Document Detail


Therapeutic Targets in Heart Failure: Refocusing on the Myocardial Interstitium.
MedLine Citation:
PMID:  24657693     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
New therapeutic targets, agents, and strategies are needed to prevent and treat heart failure (HF) after a decade of failed research efforts to improve long term patient outcomes, especially in patients following hospitalization for heart failure (HHF). Conceptually, an accurate assessment of left ventricular (LV) structure is an essential step in the development of novel therapies because heterogeneous pathophysiologies underlie chronic HF and HHF. Improved LV characterization permits the identification and targeting of the intrinsic fundamental disease modifying pathways that culminate in HF. "Interstitial heart disease" is one such pathway, characterized by extracellular matrix (ECM) expansion that is associated with mechanical, electrical, and vasomotor dysfunction and adverse outcomes. Previous landmark trials that appear to treat "interstitial heart disease" have been effective in improving outcomes. Advances in cardiovascular magnetic resonance now enable clinicians and researchers to assess the interstitium and quantify ECM expansion using extracellular volume fraction (ECV) measures, and other derangements in cardiovascular structure. These capabilities may provide a mechanistic platform to advance understanding of the role of the ECM, foster the development of novel therapeutics, and target specific disease modifying pathways intrinsic to the ventricle. Refocusing on the interstitium may potentially improve care through the identification and targeted treatment of key patient subgroups.
Authors:
Erik B Schelbert; Gregg C Fonarow; Robert O Bonow; Javed Butler; Mihai Gheorghiade
Related Documents :
9825043 - Circadian variations in cardiovascular function and their relation to the occurrence an...
20177833 - Clinical significance of ischemic electrocardiographic changes during stress myocardial...
6505893 - Peri-operative management and administration of anaesthesia in children with congenital...
Publication Detail:
Type:  REVIEW     Date:  2014-3-6
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  -     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Association of Electrocardiographic and Imaging Surrogates of Left Ventricular Hypertrophy with Inci...
Next Document:  Abnormal Repolarization as the Basis for Late Potentials and Fractionated Electrograms Recorded from...